Healthcare Provider Details

I. General information

NPI: 1093250052
Provider Name (Legal Business Name): ABOVE ALL PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2016
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 TOLL HOUSE AVE
FREDERICK MD
21701-4519
US

IV. Provider business mailing address

808 TOLL HOUSE AVE
FREDERICK MD
21701-4519
US

V. Phone/Fax

Practice location:
  • Phone: 240-815-5617
  • Fax: 240-815-5638
Mailing address:
  • Phone: 240-815-5617
  • Fax: 240-815-5638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name: JOHN CAVELL
Title or Position: OWNER
Credential:
Phone: 240-815-5617